Cancer Survivorship: Late Effects and Advanced Disease in Older Adults
Presented by Nicole L. Stout
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Nonfinancial: Nicole Stout is a member of the WHO Development Group on the Package of Essential Interventions in Cancer Rehabilitation. She is also a steering committee member of the Exercise is Medicine™ Moving Through Cancer Task Force.
Cancer-treatment-related side effects often have multisystem impact that negatively impacts function. Many side effects that occur during cancer treatment may persist and continue to cause impairment and functional morbidity after treatment is completed. Further, some side effects of treatment may not present until years after treatment is complete. This course takes a multisystem approach to understanding the physical, cognitive, and psychosocial late effects associated with cancer treatment. It also explores advanced cancer treatment, as the continuum of care for individuals with advanced cancer may be much longer, inciting a greater burden of side effects. The course covers assessment for common late effects, evidence-based interventions, and safety considerations.
Meet your instructor
Nicole L. Stout
Dr. Nicole L. Stout is a research assistant professor in the School of Medicine, Department of Hematology/Oncology at West Virginia University Cancer Institute and with the School of Public Health, Department of Health Policy, Management, and Leadership. She also serves as the associate director of the WVU Cancer Institute’s…
Chapters & learning objectives
1. Cancer Treatment Late Effects
Late effects of cancer treatments occur months or years after cancer treatments are completed and can negatively impact various body systems. Late effects contribute to loss of function as an individual ages and may magnify age-related functional changes. This chapter covers common late effects of past cancer treatments, treatment toxicities, and consideration for adaptations to the rehabilitation plan of care.
2. Managing Late Effects Alongside Age-Related Comorbidities
Older adults have unique needs after cancer treatment and throughout the remaining lifespan. Aging introduces multisystem changes, comorbidities, and pharmacologic interventions that can be influenced by the late effects of cancer treatments. This chapter covers common age-related morbidity, how it is influenced by cancer treatments, and evidence-based interventions.
3. Cancer Recurrence and Progressive Disease in Older Adults
Cancer that was treated in the past may recur and become progressive over time. Recurrence of disease introduces new and often novel anticancer treatments that negatively influence function in older adults. This chapter covers common patterns of disease recurrence and special considerations for rehabilitation interventions with advanced or progressive disease, including mobility restrictions with bone disease, critical thresholds of blood markers, and cognitive adaptations with brain and central nervous system involvement.